Up to one-third of patients with a previous asthma diagnosis show no evidence of the condition upon further evaluation – so GPs should be prepared to re-evaluate, according to respiratory GP Dr Steve Holmes.Dr Holmes says: ‘When I see somebody and I think it’s asthma but the FeNO is normal and the eosinophils are normal, and then I send them for spirometry and that test is normal too, quite often at each time they come back with those normal results, I’m re-evaluating whether it is actually asthma or not.’As well as a...
Up to one-third of patients with a previous asthma diagnosis show no evidence of the condition upon further evaluation – so GPs should be prepared to re-evaluate, according to respiratory GP Dr Steve Holmes.
Dr Holmes says: ‘When I see somebody and I think it’s asthma but the FeNO is normal and the eosinophils are normal, and then I send them for spirometry and that test is normal too, quite often at each time they come back with those normal results, I’m re-evaluating whether it is actually asthma or not.’
As well as asthma diagnosis, this podcast covers current challenges in asthma management, including overuse of short-acting bronchodilator inhalers, and the shift towards maintenance and reliever therapy (MART) and on-demand anti-inflammatory reliever (AIR) therapy. Dr Holmes also touches on current developments in management of COPD, and pitfalls in acute respiratory assessment.
Educational objectives
After listening to this podcast, healthcare professionals should be better able to:
- Recall the percentage of people with an asthma diagnosis who do not actually have asthma
- Ensure that they are following guideline-based recommendations for asthma diagnosis
- Proactively find patients who are overusing short-acting bronchodilator inhalers
- Reflect on how best to transfer patients to MART and AIR therapy
- Consider how to promote face-to-face inhaler technique coaching by healthcare professionals
- Identify normalised breathlessness so as to pick up more cases of COPD
- Consider how to identify COPD patients who might benefit from referral for biologic therapy
- Prioritise respiratory rate in acute assessment, and be aware of the limitations of pulse oximeters
You can access the website version of this podcast, along with a list of key learning points, on MIMS Learning - and make notes for your appraisal. MIMS Learning offers hundreds of hours of CPD for healthcare professionals, along with a handy CPD organiser.
Please note: this podcast is presented by medical editors and discusses educational content written or presented by doctors, nurses and other healthcare professionals on the MIMS Learning website and at live events.
Useful resources
MIMS Learning
Guidance update: BTS/NICE/SIGN guidelines on diagnosis, monitoring and chronic asthma management
Challenges in respiratory care learning plan
MIMS
MIMS table on asthma and COPD preparations and compatible devices
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